Aortic Nontouch Off-Pump Complete Revascularization Using 3 In Situ Arterial Conduits: Bilateral Internal Mammary Arteries and Gastroepiploic Artery
DOI:
https://doi.org/10.1532/HSF98.200341001Abstract
Background: Arterial grafts have been used frequently in recent coronary artery bypass grafting (CABG). Off-pump CABG can facilitate early patient recovery. A combination of in situ graft and off-pump technique results in complete aortic non-touch surgery; however, outcome has not been well established.
Methods: Between May 1998 and December 2001, 1035 consecutive isolated CABG operations were performed at Juntendo-Shin-Tokyo Hospital Group. Of these, off-pump CABG using in situ bilateral internal mammary arteries and in situ gastroepiploic artery was performed in 48 patients (41 men and 7 women; mean age, 74.5 ± 9.9 years). Perioperative and follow-up data were studied.
Results: The average number of distal anastomoses was 3.4 ± 0.7, and complete revascularization was achieved in all patients. There were no hospital deaths. Perioperative myocardial infarction was observed in 1 patient, congestive heart failure in 1, stroke in 2, and mediastinitis in 1. Postoperative catheterization was performed in 30 patients and revealed no graft occlusions. During the follow-up period of 2.3 ± 1.2 years, no remote deaths, angina recurrence, or coronary interventions were observed.
Conclusion: Off-pump CABG using an all in situ arterial graft can be performed safely, and follow-up results are excellent.
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